1952325607 NPI number — VIJAY K. CHADHA, MD, P.C.

Table of content: (NPI 1952325607)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952325607 NPI number — VIJAY K. CHADHA, MD, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VIJAY K. CHADHA, MD, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952325607
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1800 TOWN CENTER DR STE 214
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RESTON
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
20190-3238
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-478-0325
Provider Business Mailing Address Fax Number:
703-478-2702

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1800 TOWN CENTER DR STE 214
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RESTON
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
20190-3238
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-478-0325
Provider Business Practice Location Address Fax Number:
703-478-2702
Provider Enumeration Date:
07/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PALMER
Authorized Official First Name:
ANNE
Authorized Official Middle Name:
L
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
703-478-0325

Provider Taxonomy Codes

  • Taxonomy code: 207RG0300X , with the licence number:  0101037696 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 01850001 . This is a "CAREFIRST" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 25258 . This is a "KAISER" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 4091709 . This is a "AETNA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 049553 . This is a "ANTHEM" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 281606 . This is a "AMERIGROUP" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 460552 . This is a "AETNA HMO" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 820600 . This is a "MAMSI" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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